Developing multinational collaborations to promote sustainable health: Lessons Learned from Research, Policy and Practice Rebecca E. Lee, PhD Professor, College of Nursing and Health Innovation Senior Sustainability Scientist, Julie Ann Wrigley Global Institute of Sustainability, Arizona State University FulbrightGarcía Robles Core Scholar, Mexico Author, Reversing the Obesogenic Environment (Human Kinetics, 2011) Fellow, Society of Behavioral Medicine
Transcript
Developing multinational collaborations to promote
sustainable health: Lessons Learned from Research, Policy and Practice
Rebecca E. Lee, PhDProfessor, College of Nursing and Health InnovationSenior Sustainability Scientist, Julie Ann Wrigley Global Institute of Sustainability, Arizona State UniversityFulbright-‐García Robles Core Scholar, MexicoAuthor, Reversing the Obesogenic Environment (Human Kinetics, 2011)Fellow, Society of Behavioral Medicine
Acknowledgements• Simón Barquera• Edtna Jáuregui Ulloa• Lucie Lévesque• Juan López y Taylor• Luis Ortiz Hernández
Karla Galavíz, Scherezade K. Mama, Ann Pacheco, Erica G. Soltero
ObjectivesAfter attending this talk, learners will be able to...1. Understand the importance of developing a
conceptual and/or theoretical framework to guide collaboration.
2. Apply principles of persuasion to enhance collaboration development.
3. Identify measurable policy, research and practice outcomes that benefit collaborators from all sides.
Outline
• History and Key Players• Multinational Collaboration• Fulbright/ANSA• Challenges and Lessons Learned• Future Directions
2001 2003 2005 2007 2009 2011 2013 2015
Moved to K
ansas City
Lucie Lévesque (ISBNPA
)
John Allegrante(ISBM
)
EdtnaJáuregui(ACSM
)
Moved to H
ouston
First trip to Mexico
Juan Lopez Y Taylor
Moved to M
exico(Fulbright)
MultinationalCollaboration
(NIH)
Pausa Activa(CIHR)
Luis Ortiz H
ernández
Moved to A
SU
CAMBIO (CIHR)
ANSA(CIHR)
History and Key Players
Why Mexico, Hispanics or Latinos and Physical Activity?
• Highly influential country on US health, economy, social and political context
• Technological leapfrogging• Emerging interest in developing scientific
capacity• Already implementing policies, practice and
programming with limited evidence• Physical activity rates are low, and may be
decreasing, particularly in children
Multinational Collaboration to Increase Physical Activity in Hispanics
Aims1. Develop a diverse
scientific partnership2. Develop a collaborative
scientific research agenda3. Disseminate findings to
the science and community
Funding Opportunity• Strategy to develop
multidisciplinaryscientific partnerships
• Funded by NCI (1R13CA162816)
• 2 years• Meetings…
Aim 1: Develop a diverse partnership
• Very successful for American researchers
• Good representation of disciplines, gender, ethnicity, language
• Engineering, demography, geography, kinesiology, physiology, medicine, psychology, and public health
• Affiliations with practice, policy
• Included trainees
Aim 2: Develop a collaborative scientific research agenda (continued)
• Theoretically grounded to address ecologic perspective (Spence & Lee 2003: Toward a comprehensive model of physical activity.)
• Developed workgroups focused on identifying gaps in the science– RE-AIM review of the internal validity of physical
activity interventions in Hispanics– Measurement of physical activity in Hispanics– RE-AIM evaluation of physical activity public programs
in Mexico• Frequent meetings
March 2012 in Guadalajara, Jalisco, Mex 22 men (n=9) and women (n=13)
March 2013 in Puerto Vallarta, Jalisco, Mex18 men (n=5) and women (n=13)
November 2012 in Houston, TX, USA 23 men (n=9) and women (n=14)
July 2013 in Phoenix, AZ, USA16 men (n=3) and women (n=13)
Aim 3: Disseminate findings to the science and community
• Publications in peer reviewed journals• Conference presentations• Presentation to government agencies
– Presentation to Jalisco Secretaría de salud y educación
– Reports to funding agencies• Community conferences• Media interviews/talk shows• Trainees
• Spanish had more reporting of reach; English more efficacy/effectiveness
• Little information about representativeness, intervention delivery or long term outcomes
• Low confidence in PA measurement--few studies reporting indicators needed to assess quality of measurement
• Little understanding of the efficacy or impact of existing programming.
Lack of available evidence to support physical activity-related policy and programming in Hispanics or Latinos in the Americas.
Fulbright/ANSA
20 neighborhoods in Mexico City 12 in Guadalajara8 in Puerto Vallarta40 kids per school, grades 3 – 5
Parental perception of safety and gender influences on children’s physical activity in
Mexico: a cross sectional study.
A multi-site study of environmental correlates of active commuting to school in
Mexican children.
Neighborhood Street Scale Elements and Physical Activity in Mexican School Children.
Characterization of the Food Environment in School Neighborhoods in Three Mexican Cities.
Physical activity and anthropometric characteristics among urban youth in Mexico.
DF Qualitative,
Principals , Teachers, Vendors,
Parents
DF, Parent Surveys
DF Student Level –Anthro, Observ.
DF Schools Level –
SOFIT, Survey, Inventories
Association of Physical Activity Resource Quantity and Quality to Physical Activities in Mexican Children.
Cognitive versus affective messages in the promotion of lifestyle physical activity.
Parental Perception of Safety and Gender Influences on Children’s Physical Activity Levels.
An investigation of associations of different modes of physical activity and body composition in Mexican elementary school students.
The Influence of Physical Education Lesson Context and Teacher Behaviour on Student Physical Activity
in Mexico
Physical activity and anthropometric characteristics among urban youth in Mexico.
A multi-site study of environmental correlates of active commuting to school in Mexican
children.
Characterization of food and beverages sold around public elementary schools in Mexico City.
Predictors of physical activity during physical education class in Mexican elementary students.
Evaluación de la implementación e impacto del Programa Acción en el Contexto Escolar (PACE).
Investigation of Physical Education Class Content, Teachers’ Behaviour, and Physical Activity in Mexican Children in Grades 3-5: Implementation Impact of National Guidelines for Action Schools.
The influence of physical education class context on physical activity in Mexican children.
Adapting the Physical Activity Resource Assessment (PARA) Instrument to Evaluate Type, Access, Size and Quality of Physical Activity Resources in Mexico.
+ trainee SafdiePhD Thesis (Q)
+ L. Tolentino, trainee (INSP)
+ trainees –H. Gharib,
K. Galaviz (Q)
DF, Environment
– PEDS, GASI, PARA
NIH GrantLee (USA)Fulbright
Barquera(MEX)
CIHR GrantLevesque
(CAN)
Physical activity resource and user characteristics in Puerto
Vallarta, Mexico
Adapting the Physical Activity Resource Assessment (PARA) Instrument to Evaluate Type, Access, Size and
Quality of Physical Activity Resources in Mexico
Jalisco Parent
SurveysDiet, PA
Jalisco Environment – PEDS, GASI,
PARA, SOPARC
Jalisco Student Level
AnthropometryObservation
Association of Physical and Sedentary Activities to Body Composition in Mexican Children.
The Association between Dietary Habits and Sedentary Behaviors in Mexican School Aged Children.
Physical Activity among Mexicans and Mexican Americans in an Ecologic Systems Framework
Building a multilevel, multidimensional, multi-‐country strategy to reduce obesity in the Mexican Diaspora: Implications for theory, practice and policy
Quality and Implementation Assessment of the Mexican National Nutrition and Physical Activity School Policy Guidelines.
The Association between Dietary Habits and Sedentary Behaviors in Mexican School Aged Children.
Association of Physical and Sedentary Activities to Body Composition in Mexican Children.
a systematic process and methodology)• Relevant measures and available data
(depends on whom you know)• Clear goal and resulting research questions
(helps focus on measurable outcomes)
Lesson #1. You’re not in Kansas anymoreMexico• Spanish/Latin American• Family oriented• Strongly faith-based
• Patriarchal • Fluidity time
• Technology/infrastructure inconsistent
• Politics and power
Canada/USA• English/Anglo American• Individualistic• Religious pluralism
• Egalitarian• Structured time
• Technology/infrastructure expected
• Politics and balanced power
Lesson #2. Walk the walk; talk the talkWe all have the same basic human needs: shelter, food, comfort of friends and family… the manifest solutions to these needs differ based on the context in which we live.
Lesson #3. You have to go and… “hang out,” a lot
Lesson #4: You have to have a solid strategy of generating contacts and allies and
building lasting collaborations• Reciprocity – Simple acts of
kindness, personalized and unexpected
• Consistency – Behave consistently with values, public commitment
• Consensus – Social proof• Authority – Respect for credible
and knowledgeable experts • Similarity – Like me. Commonalities,
and compliments• Scarcity – We want more of what
we can’t have. Unique and rare Cialdini R. Six Principles of Persuasion.
Lesson #5. Develop shared goals
• Develop shared goals with diverse range of stakeholders
• Adds “buy in” and prevents “social loafing”• Inspires cooperation and competition• Every member of a shared goal group has to
do her or his part to achieve the goals of the collaboration, increasing energy, productivity and rapidity
• Respond to requests for information about funding priorities
• When funding opportunities arise– Be nimble and agile– Be opportunistic – Be aggressive and persistent
• Smile a lot J
Lesson #7. Have a back up plan• Things change…
– Policy priorities– Collaborators– Resources
Conclusions
• Have courage and be persistent• Treat collaborators as treasures• Meet as many people as possible• Apply kindness toward self and others• Plan ahead for all possibilities• Cast a wide range of outcomes• Mind the capacity
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